When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer

Caitlin J. Cain, Andrea R. Meisman, Kirstin Drucker, Evrosina I. Isaac, Tanvi Verma, Jordyn Griffin and Jennifer M. Rohan
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Caitlin J. Cain: Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
Andrea R. Meisman: Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
Kirstin Drucker: Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
Evrosina I. Isaac: Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
Tanvi Verma: Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
Jordyn Griffin: Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA
Jennifer M. Rohan: Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23219, USA

IJERPH, 2020, vol. 17, issue 6, 1-8

Abstract: Previous research suggests that children and adolescents with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) often have difficulty adhering to complex treatment regimens during the maintenance phase of therapy. Measurement of treatment adherence can be done via objective (e.g., electronic monitoring (EM), pharmacological assays) or subjective methods (patient, parent, or physician reports). This paper provides an illustration of recommended strategies for comparing discrepancies between two objective measures of medication adherence (e.g., behavioral adherence using electronic monitoring versus pharmacological adherence using 6-mercaptopurine (6MP) metabolite data) within a relatively large cohort of pediatric patients with ALL or LBL ( N = 139) who had longitudinal data for both measures of medication adherence over a 15-month period. Additionally, individual- and family-level factors such as gender, socioeconomic status, household environment, and dose intensity will be examined to identify possible sources of discrepancies between adherence measures. This information will provide practical advice for physicians, healthcare providers, and psychologists in identifying nonadherence and the caveats therein so patients achieve the best possible health outcomes.

Keywords: adherence; electronic monitoring; cancer; metabolites; pharmacology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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